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Practices to manage long Covid patients as specialist clinics suspended

Practices to manage long Covid patients as specialist clinics suspended

General practices in Essex are set to manage patients with long-term symptoms of Covid-19 as clinics have been temporarily suspended across the area.

It comes as Essex is facing an ‘ongoing critical incident’, with severe pressures across the NHS leading to rationing of home oxygen supplies for patients.

GP leaders warned that the workforce is being stretched ‘too thinly’ and will burn out ‘sooner or later’.

Last month, new NICE guidance recommended that practices should consider referring long Covid patients to specialist clinics as soon as four weeks after acute infection, after ruling out other diagnoses.

But Mid and South Essex CCGs told practices earlier this month that local long Covid clinics have been suspended for six weeks due to ‘system pressures’.

An email briefing said: ‘In direct response to the growing levels of Covid infection and subsequent increase of admissions into our acute and community services, we are unfortunately having to suspend the provision of Long Covid Clinics for a period of six weeks. 

‘While the suspension is disappointing, it is in line with guidance from NHS England and NHS Improvement.’

It added that ‘complex’ referral numbers have so far been ‘low’ but that practices should use ‘existing secondary care pathways to gain support’ if they have ‘significant concerns’ about their patients and believe they cannot wait to be seen.

Meanwhile, home oxygen services are rationing supplies in Essex as hospitals in the area struggle with high oxygen demand, forcing some patients to be transferred to alternative sites.

The email briefing said: ‘In response to the material growth in oxygen usage within hospitals, at vaccination centres and by ambulance services, BOC, as a provider of oxygen cylinders to the whole NHS as well as in patients’ homes, is being asked to meet an unprecedented demand for cylinders for acute/Covid need.’

While demand is ‘currently under control’, BOC will ask patients for permission to reduce their home oxygen supply on a ‘temporary basis’ to ‘mitigate risks’ of a ‘further increase’, it added.

This will apply to patients who have not replenished their oxygen supply ‘for some time’ and who are due a service or risk assessment, as well as those calling for a top-up who are ‘not a high-user requiring frequent replenishment’.

Patients ‘will be able to keep’ both current or newly-prescribed home oxygen supplies if they express any ‘anxiety or concerns’, it said.

The email briefing added that Southend hospital is facing ‘rising numbers’ of Covid patients and those requiring high levels of oxygen are being transferred to other hospitals with higher capacity.

High rates of Covid in the area are causing an ‘ongoing critical incident’ with ‘severe pressures within the whole health and care system across Essex’, the CCGs added.

Essex LMC chief executive Dr Brian Balmer told Nursing in Practice sister publication Pulse that GPs are ‘already up to their eyes’ but warned that there is ‘only so much people can do’.

He said: ‘The thing I’m most worried about is stretching our staff too thinly. It is quite extraordinary the amount of extra work that people have taken on. 

‘But it does worry me that sooner or later they will fall sick. We’re just going to wear them out.’

The LMC is working on a local clinical agreement across the system to ‘cover GPs as much as possible’ while they are having to look after patients in the community who would normally be in the hospital, he added.

It comes as Pulse revealed that GPs in Essex have been asked to go into hospitals and help discharge patients to free up capacity.

Last month, NHS England announced that 69 long Covid clinics were in place around the country, with more sites expected to open in January.

But GPs warned that access to the clinics is patchy, with only one fifth (21%) of GPs saying they currently had access to a clinic in their local area.

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